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The Medicines Control Agency (MCA) has advised all manufacturers of HRT products to revise their data sheets. HRT is now contra-indicated in patients with thromboembolic disorders, active DVT or a history of DVT. As the risk of DVT is increased with immobilisation, trauma or surgery, extra attendtion to prophylactic measures is needed for patients on HRT. Where prolonged immobilisation is likely following elective surgery consideration should be given to stopping HRT four weeks before the surgery.

Before prescribing HRT the potential benefits and risks should be considered carefully.

HRT effectively relieves vasomotor symptoms and in most cases 2-3 years therapy is sufficient. Some women may need longer; this judgement should be on a case by case basis with regular attempts to discontinue. Symptoms may recur for a short time on stopping HRT.

HRT should only be used for the prevention of osteoporosis in women who are unable to use other alternative treatments.

Women taking HRT are more likely to develop venous thromboembolism (VTE), especially in the first year of using HRT, but absolute risk remains low. (Absolute risk of VTE is 1 in 10,000 per year in non-users and 3 in 10,000 per year in users). There is a caution in those with a personal history or strong family history of VTE. See link above.

HRT does not protect against heart disease.

HRT is associated with a slight increase in breast cancer; the risk increases with duration of use. Among 1000 women who use HRT continually over 5 or 10 years starting at 50, an estimated extra 2 or 6 breast cancers would occur, raising the incidence from the usual 45 cases per 1000 to 47 and 51 respectively. Short-term use of HRT for less than 2 years is associated with no appreciable increase in risk. For more detail see Drug Safety Update, September 2007.

Ovarian cancer is uncertain and may be associated with an increased risk.

On this website you will now see four icons for these resources rather than two. Please use BNF Legacy or BNF for Children Legacy as these will take you to the original format of the online publications which do not have any errors or omissions.